Senior Center Newsletter - 2013 August

Newsletter

Mary Ann Young
Senior Center Newsletter
August 2013
Mary Ann Young
Senior Center
Mission Statement:
“To enrich the lives of
older adults by
providing educational,
recreational,
nutritional, social,
informational, and
volunteer opportunities
in a relaxed, friendly
environment.”
Senior Center Staff:
Shelley Johnson,
Director
Ann Genosky,
Coordinator
Newsletter
Assemblers:
Shirley Gatzke
Ivan Arndt
Marcia McKee
Gloria Schmidt
Frank Schmidt
Maxine Nystrom
Fran Tadych
Jim Grant
Patti Sandin
Alice Nasland
Lori Schintgen
Joyce Bachelor
*If you visit the Center
weekly, please save on
postage and let us know
you will pick up an issue
of the newsletter.*
This newsletter is made
possible through the
continued support of the
City of Blaine.
9150 Central Avenue NE – Blaine MN 55434
(763) 786-9375 – (763) 780-4318
Mondays
9:00a
10:45a
1:00p
1:00p
1:00p
2:30p
3-9 p
6:00p
Walking Group-8/5, 8/12, 8/19
Enhanced Fitness
Penny Bingo
Nickel Bingo-8/26
Senior Bowling at Brunswick Zone
Health Insurance Appts.-8/5, 8/19
Quilting Group-8/26
Garden Club Tours-T.B.D.
Saturdays
9:00a
10:00a
11:00a
1-5p
Beginner Line Dance
Advanced Beginner Line Dance
Intermediate Line Dance
Line Dance Party-8/17
Sundays
1-4:30p North Country Jamboree
performs- 8/18
Tuesdays
9:00a
9-2
11:15
9-2
11:15
1:00p
1:00p
5:30p
7:00p
Line Dance
Wii Bowling (Make up)-8/13
Wii Bowling Banquet-8/20
Wii Open Bowling-8/27
National Noon Out-8/6
Blood Pressure Checks-8/13, 8/20
Progressive “500” Cards
T.O.P.S. weigh-in, 6:00 pm mtg.
Woodcarving Group
Wednesdays
10:00a
10:00a
11:00a
11:00a
12:45p
1-3p
1:00p
2-4p
6-8p
Access our Website
Direct Link:
http://www.BlaineParks.com and
then click on the Senior Center page.
Choose from the list of topics by
clicking on your selection:
Amenities
Current Menu
Calendar of Events
Current Newsletter
Programs and Events
Anoka County Services
Computer Q & A Session-9/4
State Services-Blind-8/21
Leaving a Lasting Legacy-8/14
B-Day Party entertainment-8/28 -------------------------------------------------------Looking for
Bunco Dice Game -8/7
Woodcarving Group
Something to Do ?
Birthday Bingo w/prizes!-8/28
The Mary Ann Young Senior Center
Hand and Foot Card Game
is open Monday through Friday 8:30
Line Dance-varied levels
am to 4:30 pm and at other
Thursdays
8:15a Harvest Dinner Ticket Sale-8/15
9-noon Home Movie Drop Off-8/15
9:30a Beginning Bridge –except 8/22
10a
Defensive Driving Class-8/8
11-2 Bring a Youth Day-8/22
12:30p Canvas Oil Painting Class-8/29
1:00p Movie: “The Guilt Trip”-8/15
1:15p Activity Comm. Meeting-8/8
6-8p
Intermediate Line Dance
specified times. Stop in and check
it out!
FOOD SUPPORT PROGRAM:
For Seniors 60+: Would you like to
“Stretch Your Food Dollars?” Would
you like to have some extra dollars to
buy fresh fruits and vegetables? Are
higher prices for gasoline, heating &
a/c, etc. leaving you with fewer
dollars to buy quality food?
Fridays
Contact your Senior
9:00a Foot Care appointments-8/9
Outreach Worker for more
9:00a Jewelry prep.-8/23
information
about this
10:00a Plastic Canvas/Crafts–8/2, 8/16
1:00p Enhanced Fitness
program at 763-783-4741, or for those
1:00p Senior Bowling at Brunswick Zone under 60 call Karen at 763-783-4892.
1:00p Open Cribbage-play 6 games
Wood Carving
News
Plan to join us for
Woodcarving
Group on
Tuesday
evenings from
7-9 pm lead by
J.D. Hughes: 763-4344202, and/or on
Wednesdays from 1-3 pm
lead by Wes Spadgenske.
They will be on hand to
assist as needed and to
answer questions about
carving. Start from the
beginning, or continue to
work on your own project
with people sharing a
common interest. All
levels are welcome! Join
us for some relaxed
conversation. The MN
Woodcarver’s Association
does not meet in the
summer months. See you
in September!
Senior Dining
Join us at the Mary Ann Young
Senior Center M-F for a
nutritious, well-balanced, tasty
meal at 12:00 noon in a
friendly, relaxed atmosphere.
Make your dining reservations three business
days in advance to secure your meal. The
suggested donation is $3.50 for those 60 years
of age and older, and the cost is $6.50 for
those under age 60.
2nd Lemon Pepper Tilapia, Wild Rice Pilaf
7th Roast Sliced Pork w/Apple Rhubarb Glaze
OR Sliced Turkey, Mashed Potatoes, Squash
8th Chicken Parmesan, Garlic Mashed
Potatoes, Green Beans & Carrots, Cake
9th Pulled Turkey, Mashed Potatoes/Gravy
13th Ham Steak OR Chicken W/Honey Mustard
Glaze, Baby Reds, Mixed Vegetables
14th Salisbury Steak w/Onion Gravy, Mashed
Potatoes
15th Herb Roasted Quarter Chicken, Buttered
Corn, Herbed Potatoes, Roll, Apple Pie!
16th Sliced Turkey on Bun, Potato Salad
19 BBQ Beef Riblet OR Pork Riblet
Join Gary
Clark
and
musicians
for a real
taste of
country
music
on the 3rd Sunday of each
month from 1-4:30p.m. It’s
awesome, it’s free…don’t
miss out, join the fun!
Next date is August 18th.
22nd Beef Hotdog, Potato Salad, Baked Beans,
Fresh Melon for “Bring a Youth to Lunch Day”
The City of Blaine Publics
Works department has
resurfaced and repainted
the courts at Carrara East
Park and Centennial Green
Park to be used for
Pickleball. The courts can
be used on a first come,
first serve basis. For more
information call Jerome at
the Parks and Recreation
office at 763-785-6161.
Appointments are now
available for Friday,
August 9th for foot
care. The cost for an appointment is just
$20. Appointments begin at 9:00a.m.
Please call the Senior Center in advance
at 763-786-9375 to register. Bring your
own towel.
FOOT CARE POLICY: If you make an
1st Western Omelet OR Cheese Omelet,
appointment for foot care and do not call
Breakfast Potatoes, Juice Cup, Muffin, Orange 24 hours in advance to cancel, you may
Country Music at its
Best!
PICKLEBALL!
Foot Care
th
21st Kielbasa & Sauerkraut OR Beef Patty
28th Beef Pot Roast, Mashed Potatoes/Gravy,
Dinner Roll, Red Velvet Cake - B-Day Party!
th
29 Healthy Baked Fish OR Chicken Breast
There are other delicious entrees during the
month. Check it out and join us as often as
you can! Please specify entrée choice, skim
milk, RCD (reduced calorie dessert) each
time you order. Thanks!
Get in the ZoneBrunswick Zone XL,
A state of the art facility
featuring 38 bowling lanes,
Brunswick sponsors Senior
Bowling on Mondays and
Fridays beginning at 1:00 p.m. for just
$1.25 per game. Stop to bowl and enjoy
free shoe rental, cookies, coffee and
loads of fun. Meet new people and plan
on a good time. Brunswick Zone is located
west of Hwy. 65 off 113th Street in
Blaine.
be charged for the appointment.
FAMILY CAREGIVER
CONNECTION:
Support groups and group respite
care are available in the Anoka
County area. Call Jill Agyekum,
Family Caregiver Connection contact
at 763-422-6960 for more
information about the assessment
process.
Plastic Canvas/Craft Class
Join Opal Peterson and friends on
Fridays, August 2nd & 16th at
10:00 a.m. to learn or share the
art of plastic canvas or spend time
with friendly folks working on a craft
project of choice.
Thank you!
*To the Wednesday Woodcarving Group
for the auction that raised funds totaling
$199, in memory of carver Arthur
Meierdiercks.
*To Jerry Schilling for the significant
donation in memory of wife, Lou.
*To Jerry Hess for multiple jigsaw puzzles
donated.
*To our Birthday Party Sponsors for July &
August: Homestead of Anoka and
Brightondale on New Brighton.
*To Joan Cameron for significant
donations in memory of husband, Bill.
*To Gladys Holm for bingo prizes.
*To Charlotte Zabel for miscellaneous
donations of books, craft supplies, etc.
Low Vision Help
Paul Mattson from the
Minnesota State Services
for the Blind will be
available by appointment
at the Mary Ann Young
Senior Center in Blaine
on the third Wednesday
of the month from
9a.m. to 12noon. If you
or someone you know has
a vision problem, please
call Paul at (651) 6420846 to schedule a visit
with him. Paul will be
glad to help with any
questions or concerns you
have regarding loss of
vision, and research
valuable tools to assist
you in daily living skills.
Next available
appointment date is
August 21st.
T.O.P.S.
T.O.P.S. (Take off
Pounds
Sensibly) currently
meets on Tuesday evenings
with weigh-in at 5:30pm and
a fun, educational meeting
at 6:00 p.m. If you are
interested in losing weight,
this may be just the right
group for you. For details,
contact Cindy Heckler at
651-310-9261 or Paulette
Kotila at 651-259-6241.
Current Events:
*Cribbage: Open cribbage will be offered
on Fridays at 1:00 p.m. beginning August
2nd. Play 6 rounds and enjoy snacks and
payback prizes for just $1 per person. No
advanced sign up required.
Karen Pollesch,
Senior Outreach Worker, ACCAP
763-783-4741
Looking for ways to stretch your dollar?
Check out these possibilities for people age
60 or better:
*National Noon Out: The Parks &
*Energy Assistance Program which helps
Recreation Department team up with the
with your utility costs. This is an income
Police and Fire Departments to bring you a eligible program you may qualify for if your
fun safety game with safety education and monthly income for one person is $1,854
a chance at prizes, on Tuesday, August 6th
(gross) and for two people is $2,424 (gross).
at 11:15a.m. Come join us!
The Energy Assistance application process
*Leaving a Lasting Legacy: Informational
runs from October 2012 to May 2013 so you
session on wills, trusts, and more on
need to reapply each year.
Wednesday, August 14th, see article this
*Food Support-SNAP-(Supplemental
issue.
Nutrition Assistance Program) to help pay
*Harvest Dinner Ticket Sale: Tickets go on for groceries. If your gross monthly income
is less than $1,536 for one person or less
sale for this favorite dinner, on Thursday,
th
August 15 at 8:15a.m. Limit 12 tickets
than $2,081 for two persons you may
per person. Dinner will be held on
qualify.
Thursday, September 26th at 5:30 p.m.
If you have questions about these programs
with the entertaining, “Four Plus One
as well as any other programs such as
Band”.
transportation, telephone assistance, medical
assistance, housing options, etc. give Karen a
*August Movie: “The Guilt Trip” starring
Barbra Streisand and Seth Rogen depicts a
call at 763-783-4741. She can come to your
road trip of a lifetime until
home or meet you at the Sr. Center in Blaine
Andy Brewster (Seth) gets
to discuss programs you might qualify for.
guilted into inviting his mother
(Streisand) along for the 3,000 mile trip.
This comical movie will be shown at 1p.m. Computer Question
on Thursday, August 15th with refreshments and Answer Session
at intermission-free!
Need help with e-mailing photos?
*Bring a Youth to Lunch Day: Plan to join Interested in buying a computer, but not sure
what kind to get? Confused by all the talk in
us on Thursday, August 22nd as we enjoy
games, lunch, bingo and ice cream from
the news about online computer scams and
11:00 a.m. – 2:00 p.m. This is a fun day for what you should be doing to protect your
the youth, so get signed up early! Cost is
privacy? Get answers to your computer and
$3.50 for lunch and $1 for ice cream.
technology questions in an open forum Q & A
session on Wednesday, September 4th at
*Birthday Party: Join us at 11:00 a.m. on
Wednesday, August 28th as we enjoy music 10a.m. Please R.S.V.P. your attendance.
LEGAL SERVICE:
by Wayne & Barb Maresh and friends,
Anoka County legal service is followed by a delicious beef pot roast meal Evening & Weekend
Line Dancing
available to
and then prize bingo at 1:00 p.m.
Wednesday night line dance
residents of Anoka
*Oil Painting Class: On display the months features beginner class at
County age 60 or
of July & August is a sample of the painting
6pm, advanced beginner
better. Free legal consult is
the class participants will complete. All
offered at the Mary Ann
class at 7pm. The
levels invited; no experience necessary. All
Young Senior Center by
Thursday evening
materials will be provided. Each finished
appointment generally on
canvas oil painting will be 16”x20”. Cost is Intermediate Line Dancing is from 6-8p.m. On
the first Tuesday of the
Saturdays, Beginning Line Dance class is at
just $50 per person for full instruction.
month beginning at
Class time is from 12:30p.m. – 3:30p.m. on 9:00 a.m., Advanced Beginner Line Dance
11:15a.m. Call 763-786-9375
class is at 10:00 a.m., and the “Keeping it
Thursday, August 29th. Sign up!
for an appointment. The
Country” Class is at 11:00 a.m. A FREE
next date is August 6th.
WILL donation per person is accepted for
music and instruction. The next Line Dance
Party is on August 17th from 1-5p.m.
“Personal” Home Movie
Transfer Service:
Eric from North Metro TV
is making a service available
for seniors at our
Center. If you
are interested in
transferring your personal
VHS tapes (such as for
family events, parties, etc.)
to a disc, he is just the guy
to handle it. Drop off your
VHS personal home movies
at the Senior Center on the
second Thursday of the
month between 9a.m.-noon,
and Eric will pick them up,
transfer the movies to a disc
at the T.V. station using
their sophisticated
equipment, and return the
updated movies to the
Center at a later date.
*SNAP Food Program:
For seniors there may be a
gap in expenses vs. income
so folks may not have the
funds they need to purchase
healthy food. The benefit
you may receive from the
SNAP program can help you
stretch your food budget.
Even a small benefit can
really add up to help. The
SNAP program is the
Supplemental Nutrition
Assistance program. Folks
are given a plastic EBT card
to use, formerly called food
stamps. Call for more
details: 1888-711-1151 or
visit
www.mnfoodhelpline.org
Prizes, Anyone?
We welcome prizes for our
Bring a Youth to Lunch
Day…any ages, but
especially for teenagers and
adults. THANK YOU!!
Outings & Tours!
Call 763-786-9375 for details.
St. Croix Casino – Turtle Lake
Register by July 31
DATE: Wednesday, August 7
TIME: 8:30 a.m. – 4:30 p.m.
FEE: $5 ($5 back at casino)
**Pick up at Blaine Senior Center
TREASURE ISLAND CASINO:
Register by September 2th.
DATE: Monday, September 9th
TIME: 8:30a.m.-4:30p.m.
FEE: $5 ($3 food coupon and 10 pull
tabs)
DEPART: Blaine Senior Center
“Baby Case” at History Theater
In 1932, a 20-month-old baby was taken
from his crib; his devastated parents, Col.
Hutchinson, MN Day Trip
Charles and Anne Lindbergh, were
Chosen as the Official Best Small Town in
suddenly at the center of a media frenzy
Minnesota, Hutchinson has a unique mix of
the like of which the country had never
small town community, industry, historical
significance, and modern convenience. Sit
seen. This Barrymore Award-winning
back and enjoy as a member of the Historic
musical follows the sensationalized
Hutchinson Society joins us for a detailed look searches, investigations, and accusations
at the many sights, buildings and homes that which led up to America’s first “trial of
are woven throughout this community
the century.” The infamous story also
situated along the Crow River. Your driving
includes Bruno Richard Hauptman,
tour will be filled with charming anecdotes,
rich history and unique tales. The Crow River Norman Schwarzkof, Sr., Walter Winchell,
Violet Sharpe, J. Edgar Hoover, Herbert
Golf Club is the setting for lunch. Downtown
Hoover, Dr. John “Jafsie” Condon, Will
Hutchinson’s Library Square is bustling with
the 39th annual Arts & Craft Festival and the Rogers, William Randolph Hearst, Ginger
Taste of Hutchinson. Shop for unique
Rogers and more! Lunch after the show at
selections of art and enjoy a wide array of
St. Paul Grill. Registration due by
tasty treats. You will have a short period of September 18.
time to enjoy these events. Register by
DATE: Thursday, October 24
August 30. Pick up will be at the Circle Pines
TIME: 8:45 a.m. - 3:00 p.m.
Credit Union - 4 South Pine Drive
FEE: $50 includes ticket, lunch and
DATE: Friday, September 13
transportation
TIME: 8:15 a.m. - 5:00 p.m.
FEE:
$66
“Cowgirls” at Old Log Theater
Branson Christmas Tour
December 3 – 7
COWGIRLS is a musical comedy that
Visit historic Branson and experience
focuses on a trio of classically
some
great holiday shows, holiday lights
trained female musicians that
tours,
shopping, excellent dining, and
is mistakenly booked to play
much
more! The holiday shows will
Hiram Hall, a country western
concert bar in Kansas. The include: Daniel O’Donnell, The Presley
Family Jubilee, Shoji Tabuchi Show,
owner of the club, Jo Carlson, must raise
Showboat
Branson Belle, and Twelve Irish
enough money during the weekend to pay
Tenors.
For
a complete Itinerary, please
off debtors or the hall will be closed.
call
763-785-6164.
Though mostly unfamiliar with country
music, the trio convinces Jo and her
employees, Mickey and Mo, to allow them
the chance to transform themselves into
Cribbage League for
legitimate cowgirl performers in time for
Seniors:
the first performance. Lunch options
Our Saturday cribbage
include: chicken, pork chop, fish, beef
league will start up in
and
vegetarian.
Registration
by September, two Saturdays a month for
September 17.
the months of Sept., Oct., Jan., Feb.,
DATE: Wednesday, October 2
March and April. League play is 8 games
TIME: 10:30 a.m. - 4:30 p.m.
starting at 12:30p.m. Call Della if
FEE:
$46 (includes ticket, lunch and
interested at 763-783-0189.
transportation)
WALKING GROUP:
Seasoned walkers should
consider joining this fun,
active group just getting
started. Plan to walk a loop
of 1-1.5 miles at various
trails around the Blaine area.
Beverly Kronstedt - (763571-7502) is organizing a
walking group at each of the
local senior centers Monday
through Friday. The “Blaine
Trail Blazers” will start off at
the Mary Ann Young Senior
Center on Mondays at 9 a.m.
on August 5th, 12th, & 19th.
Plan to meet at the Center
on designated Mondays to
carpool to various local
trails. Paths are paved for
easier/safer walking, but
wear good walking shoes and
comfortable clothing.
Bring a Youth to Lunch:
We have planned a fun, intergenerational day
on Thursday, August 22nd beginning with
games at 11:00 a.m., noon “state fair style”
luncheon (hot dog, chips,
watermelon for the kids)
for $3.50 each, 1pm prize
bingo and 2pm Ice Cream
Sundae for just $1 each. Register in advance
and plan on a good time!!
GET WELL:
We extend get well wishes to our friends
on the mend:
• Opal Peterson
• Alice Arndt
Jewelry Donations Accepted:
Our annual sale will be here before you
know it. We are now accepting donations
of jewelry for our sale, which is our main
fundraiser for the year and will be held in
October. If you or someone you know has
Oil Painting Class: unwanted jewelry items,
Paint a professional looking we would love your
work of art on canvas in one donation for our sale.
day! All supplies and Thank you in advance to those who have
instruction included. already donated items this year or in past
years. If you are interested in helping
Go home with a
the sale, come in on Friday,
beautiful finished prepare for
rd
August
23
at
9 a.m.
product that
measures 16” x 20”!
Register to participate in this
class to be held on
Thursday, August 29th from
12:30-3:30p.m. Cost: $50.
LEAVING A LASTING LEGACY:
FREE ONE-ON-ONE HEALTH INSURANCE
COUNSELING ABOUT MEDICARE
Free health insurance counseling to
Medicare beneficiaries will be provided by
state-certified Metropolitan Area Agency
on Aging staff or volunteers at the Mary
Ann Young Senior Center in Blaine, on
specified Monday afternoons.
Appointments are required. Counselors
will assist with the basics of Medicare and
Medical Assistance, choosing a
supplement and/or a Part D plan,
processing claims, assisting with forms,
and more. To schedule a one-hour
appointment, call 1-800-333-2433 and ask
to schedule an appointment at the Mary
Ann Young Senior Center.
IN SYMPATHY:
We extend our heartfelt
sympathy to the family and
friends of:
• Angie Ryan age 94, mother
of Mayor Tom Ryan
• Lucille (Lou) Schilling, survived by
husband of 58 years, Jerry.
These special people will be missed by
many.
Over 60 or an adult
Wills, Trusts, Probate, Incapacity Planning,
and Documenting Your Life Story. Join us
with a disability??
on Wednesday, August 14th, 2013 at 11am. ACCAP Chores & More
At this presentation you will learn:
·The difference between a Will and a
Trust and discover which one is handled
Quilting Group
privately and which one is of public
All levels of experience
record.
welcome! The next
·How to avoid probate and pass the
scheduled
maximum amount of your estate to your
quilting date at
family?
the Mary Ann
·How you can plan for incapacity and
Young Senior
make sure your wishes are carried out
Center is Monday, August
exactly as you want?
26th from 3-9p.m. You can
·About Long-term care planning
also quilt at Blaine United
including government benefits such as
Methodist Church on 115th MNCare and medicare and long-term care
Avenue (763-757-2170) on insurance.
·The value of building your legacy as
Wednesday evenings from
part
of your estate plan.
3-9 p.m., bring a dish to pass
for the potlucks. Questions? This complimentary presentation is
provided by attorney Chuck Roulet.
Call Lucy at 612-220-6510.
Please register early to reserve your seat.
YOUR ONE STOP SHOPPING FOR:
MINOR HOME REPAIRS
HOUSEKEEPING
SEASONAL CHORES
CALL JUDY- 763-767-6521
We are sorry to announce that we are no
longer serving the under 60 population
due to funding issues.
FUNDING IS PROVIDED BY THE OLDER
AMERICAN ACT GRANT THROUGH THE
MINNESOTA BOARD ON AGING AND THE
METRO AREA AGENCY ON AGING. CHORES &
MORE IS A PROGRAM OF THE ANOKA COUNTY
COMMUNITY ACTION PROGRAM WITH
FUNDING FROM THE CITIES OFANOKA AND
COON RAPIDS.
ACCAP Chores & More does not discriminate
based upon a person’s race, color, national
origin, sexual preference, or religious
affiliation.
Mary Ann Young
Senior Center
PRSRT STD
U.S. Postage Paid
Twin Cities, MN
Permit #4190
9150 Central Avenue NE
Blaine MN 55434
(763) 786-9375
Address Service Requested
Defensive Driving Refresher Course
Our Defensive Driving Classes fill quickly, so plan ahead for when you are due. The next class
is scheduled for August 8th and is full. The fall dates are as follows: September 5th, October 3rd,
November 7th. You must have taken the full 8-hour class in order to be eligible to take the 4hour refresher. The Refresher classes are held from 9:45a.m to 2:30p.m., with a half hour
lunch break. You must register and pre-pay for the class, which will be conducted by an
instructor from the American Association of Retired Persons. Upon completion of the class, a
certificate is issued and will be accepted by Insurance Companies for a discount on premiums
for person’s 55 years of age and older. This certificate is good for (3) years and therefore
must be repeated. This is a lecture-video class. The AARP rate is $12 for members and $14
for non-members. Make all checks payable to “A.A.R.P.” You must show and record your
AARP member number (if applicable) on the form you complete at the refresher class.
Lunch is available for the refresher class for a suggested donation of $3.50 per person age 60
and(763)780-4
up. If you are not age 60, the lunch cost is $6.50. Please pay for lunch on the day of
class, but you must register at least three days in advance for the meal. Checks for the meal
need to be written out to “V.O.A.”. Coffee and treats are provided for a suggested donation
of $1. Please bring your driver’s license and AARP Card (if applicable) to class with you.
Because classes fill so quickly each month, be sure to plan at least six to eight weeks in
advance of your needed date. To register, call the Senior Center first, then mail in your AARP
payment to the Mary Ann Young Senior Center address: 9150 Central Ave. N.E., Blaine, 55434,
or stop by the Center in person to complete your transaction. Pre-payment is required to
secure your reservation. A 48-hour cancellation notice is needed to receive a refund. **
Senior Center office hours: Monday through Friday 8:30 a.m.-4:30 p.m. Would you like a
lunch reservation? ___Yes ___No
Date of Class_____________ Date of Birth______________
Name
Phone__________________________
Address
City_________________________________ State______________ Zip___________